Since ancient times, mankind has been fighting intestinal tuberculosis. This is a serious and dangerous disease that, if untreated, can lead to death. Everyone should know how this ailment is manifested. So what is intestinal tuberculosis? What symptoms are characteristic of it?
The essence of intestinal tuberculosis
Tuberculosis is an illness that is known to all people. Under this term, specialists understand a chronic infectious disease. Many people think that this disease is associated only with damage to the respiratory system. In fact, this is not so. Extrapulmonary varieties of the disease exist. One of them is intestinal tuberculosis. There is a named disease due to mycobacteria. One of the sources of infection is patients who do not follow the rules of personal hygiene.
Such people secrete mycobacterium tuberculosis (MBT) and infect several people over the course of a year. Cattle are also sources of infection. Mycobacterium tuberculosis is highly resistant to environmental factors. With various effects, microorganisms can become ultrafine filtering particles or giant branching structures. In favorable conditions, the office takes on typical forms.
Forms of Intestinal Tuberculosis
The named disease is divided into primary and secondary. How is intestinal tuberculosis transmitted, what causes it? The answer to this question is worth giving. So, primary tuberculosis occurs for several reasons:
- Due to the use of unboiled milk of tuberculosis cows.
- With hematogenous dissemination of Mycobacterium tuberculosis from the primary focus in the lungs, lymph nodes.
- Due to the consumption of food from dishes that are infected with Mycobacterium tuberculosis, or from a container that belongs to people with this disease.
The secondary form of the disease occurs in sick people with affected lungs due to swallowing sputum and saliva. Mycobacterium tuberculosis in this way enter the intestine and infect its wall (mainly affect the ileum). As a result, fistulas and ulcerations occur. Is intestinal tuberculosis dangerous to others? Statistics show that usually the disease is a secondary process that occurs during the progression of the pulmonary form. Much less often, intestinal tuberculosis is primary, developed due to nutritional infection.
Symptoms of the disease
With intestinal tuberculosis, people notice the following suspicious signs:
- Symptoms of intoxication. Due to the disease, appetite is lost, body weight begins to decrease. Patients complain of night sweats, fever. Women may not have menstruation.
- Intestinal symptoms. At the onset of the disease, some people experience constipation. After it follows, as a rule, prolonged and draining diarrhea. Specialist patients also complain of abdominal pain.
- The presence of education. On palpation of the abdomen, a slightly painful tumor can be felt.
With ulcerative-destructive lesions of the intestine, symptoms of peritoneal irritation occur. Patients have a fever. Blood is visible in the feces or there are its components (red blood cells, white blood cells), which are detected by specialists during a study using a microscope. Complications may be characteristic of the ulcerative-destructive process. Often there are bleeding, intestinal obstruction, a violation of the integrity of its wall.
Tuberculosis diagnosis
The diagnosis of "intestinal tuberculosis" can be made by specialists after a comprehensive examination. It includes:
- tuberculin tests;
- roentgenography;
- colonoscopy;
- irrigoscopy;
- laparoscopy with biopsy.
Quite informative methods are computed tomography and laparoscopy. During the application of these diagnostic methods, specialists often find calcified mesenteric lymph nodes, tuberculous tubercles in patients. Informative and X-ray examination. Thanks to him, experts detect signs of intestinal tuberculosis (for example, delayed barium in the cecum when other departments are released).
The quantiferon test is a modern laboratory method that allows you to identify an infection. When covering the diagnosis of tuberculosis, it is worth considering it. So, the essence of the test is to examine the patient’s blood. She surrenders in the morning on an empty stomach from a vein and is placed in a special kit consisting of three test tubes. After blood sampling, specialists conduct a study. Quantiferon test can give a positive, negative and doubtful result:
- A positive result indicates infection of the office.
- Healthy people get a negative result. However, it is worth noting that with it, one should not exclude infection with tuberculosis mycobacteria. The result may be false negative. This happens in the early stages of infection, with immunodeficiency conditions.
- A dubious result is possible with individual characteristics of the immune system, as well as in violation of preanalytical requirements. For more information, doctors decide to take new blood or to schedule additional examinations.
Differential diagnosis
Those signs that are identified by specialists during an examination of people with suspected intestinal tuberculosis may be characteristic of other inflammatory diseases. This ailment has much in common with ulcerative colitis, Crohn's disease, amoebic dysentery, and intestinal neoplasms. For a correct diagnosis, differential diagnosis is necessary:
- To verify the absence of amoebic dysentery and neoplasms, a histological examination should be performed.
- Due to endoscopic biopsy, sarcoid-like granulomas consisting of lymphocytes with large cells of the Pirogov-Langhans type in the center can be detected. Such structures are characteristic of intestinal tuberculosis and Crohn's disease. You can distinguish these diseases from each other according to the foci of caseous necrosis. They occur with granulomas only with intestinal tuberculosis.
Disease treatment
With the diagnosis of intestinal tuberculosis, treatment begins in specialized hospitals. Its goal is the persistent healing of foci of infection, the elimination of symptoms of the disease. The treatment for tuberculosis is quite lengthy. Recovery on average occurs in a year. In some cases, it takes much longer to heal.
With intestinal tuberculosis, complex treatment is necessary. Its main component is chemotherapy. Doctors choose specific drugs, determine their combinations, doses. At the beginning, intensive chemotherapy is performed. It inhibits the reproduction of mycobacteria, helps to reduce their number. Regarding treatment regimens, it is worth noting that every day can be applied:
- "Isoniazid" and "Rifampicin";
- "Isoniazid" and "Ethambutol."
The first combination of drugs is prescribed for a period of 9 to 12 months, and the second for 18. Such a long treatment is necessary due to the fact that mycobacteria multiply slowly and can remain inactive for a long time.
If diagnosis of intestinal tuberculosis is detected, then conservative treatment will not necessarily be prescribed. It is not in all cases capable of producing the expected result. Sometimes doctors prescribe surgical treatment. It is indicated for the development of complications. For example, an operation may be prescribed if there is a large amount of fluid in the abdominal cavity. Surgical intervention also requires mechanical intestinal obstruction. The causes of its occurrence may lie in the scars and adhesions between the loops of the intestine remaining after the cure.
Treatment Issues
The main problem associated with the treatment of intestinal tuberculosis is the lack of discipline of sick people. Many patients do not follow the recommendations of specialists and interrupt their tuberculostatic drugs. Due to the premature termination of chemotherapy, the process worsens. Another problem is that after taking the prescribed drugs, side effects may appear. Serious effects of the toxic effects of drugs are:
- Hepatitis is an inflammatory disease of the liver.
- Thrombocytopenia is a condition characterized by a decrease in platelet count.
- Neuritis is an inflammatory disease of the nerves.
- Renal failure is a pathological condition characterized by impaired renal function.
Side effects do not appear so often. They are encountered by 3-5% of people receiving Rifampicin and Isoniazid, and 1-2% of patients treated with Isoniazid and Ethambutol. If side effects occur, the treatment program changes.
The consequences of intestinal tuberculosis
The prognosis for the disease depends on how timely specialists diagnosed the disease and prescribed therapy. In advanced cases and with destructive lesions of the small intestine, the prognosis is unfavorable due to relapse of intestinal obstruction and impaired absorption of nutrients. A less pessimistic prognosis is given for lesions of the colon.
Disease prevention
In order to prevent the development of intestinal tuberculosis, preventive treatment is carried out. In order to determine whether a particular person needs him, a preliminary formulation of tuberculin samples is performed. If the result is positive, then preventive treatment is prescribed. It consists in carrying out chemoprophylaxis with Isoniazid for 1 year. Prevention is carried out not only with a positive tuberculin test to avoid a disease such as intestinal tuberculosis. The reasons for her appointment may be as follows:
- A person often comes in contact with people who have active tuberculosis.
- The patient takes corticosteroid and immunosuppressive drugs.
- A person suffers from immunodeficiencies of various origins.
In conclusion, it is worth noting that with the appearance of suspicious symptoms characteristic of intestinal tuberculosis, you should immediately contact a physician in a clinic. If a specialist suspects the named disease, the patient will be referred to one of the specialized TB facilities.